abnormal psych: personality disorders

  1. Personality disorders
    enduring characteristic ways of feeling, thinking and behaving that cause impairment in functioning and that begin in adolescence or early adulthood.

    Axis II Personality Disorders (PDs) represent person’s normal way of functioning which is dysfunctional i.e. he/she, family and friends say “that’s just who he/she is”
  2. characteristics of personality disorders
    Importance of stability across time and situations.

    Some characteristics are unusual and appropriate to the situation. For example, person can become dramatic if giving a presentation, somewhat odd if under great deal of stress.

    Temporally, someone can evidence more instability in their youth compared to later in life
  3. assesment of personality disorders
    clinical impression

    collateral information (from friends and family)

    pyschological testing
  4. DSM-IV Diagnostic categories of Personality Disorders
    • Cluster A- odd-eccentric
    • Cluster B- dramatic-hostile
    • Cluster C- avoidaint-anxious
  5. Schizotypal Personality Disorder
    • Cluster A
    • postive symptoms of schizophrenia
    • Five or more of the following:

    •Ideas of reference

    •Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, bizarre fantasies or preoccupations)

    •Unusual perceptual experiences, including bodily illusions

    •Odd thinking and speech (e.g., vague, circumstantial, metaphorical)

    •Suspiciousness or paranoid ideation

    •Inappropriate or constricted affect

    •Behavior or appearance that is odd, eccentric, or peculiar

    •Lack of close friends or confidants other than first degree relatives

    •Social anxiety that tends to be associated with paranoid fears
  6. Paranoid Personality Disorder
    Cluster A

    pervasive and unwarranted mistrust of others. May become aggressive to challenges, may withdraw. More common among men, increased risk for anxiety, depression, psychosis.
  7. Schizoid
    Cluster A

    lack desire for interpersonal relationships, thinks they are messy and intrusive. Lack good emotional range. Presents with negative symptoms of Schizophrenia.
  8. Borderline Personality Disorder (BPD)
    Cluster B

    Symptoms: hypersensitivity to abandonment, clinging to others, history of hurting self. Instability in mood and self concept, instability in interpersonal relations. Impulsive self damaging behaviors

    –Not able to integrate positive and negative aspects of self – defense mechanism of “splitting”

    –Are more likely to report trauma, neglect, abuse in childhood.

    Marsha Linehan argues parents discouraged emotional experience, this is why they cannot accept their own emotional reactions to others.

    –Dialectical Behavioral Therapy (DBT) effective

    –Medications typically are antianxiety, antipsychotic
  9. Antisocial Personality Disorder (ASPD)
    Cluster B

    –pervasive behavior that violates social norms

    –few positive relationships,

    –more often commit violent criminal acts

    –Impulsive (linked to low serotonin)

    –sensation seeking

    –lacks remorse

    –50-80% men in jail diagnosable

    -deminishes with age

    -ADHD or conduct disorder in childhood

    –some evidence that low arousal (by GSR and EEG) leads to low fear, which leads to impulsivity. Another theory is that low arousal is uncomfortable and they need stimulation. Becomes antisocial with poor upbringing
  10. Histrionic Personality Disorder
    Cluster B

    need for attention

    Exaggerate medical problems

    Cognitive theories focus on helping them discover they can manage on their own without need for attention.
  11. NarcissisticPersonality Disorder
    Cluster B

    – dramatic and grandiose as histrionics but completely self involved. Exploit others for power.

    –Narcissism is phase we all go through according to Freud. If fixated here, they become adults.

    • Cognitive – unrealistic evaluations of self. Rarely seek treatment. CBT can help develop realistic evaluations of self
  12. Avoidaint Personality disorder
    • Cluster C
    • avoids others due to anxiety

    Prevalence 1-7%

    Prone to depression, anxiety

    Similar to social phobia but avoidants’ fears are more global, not specific to social performance

    Cognitive theories suggest they become avoidant bc of rejection from family members. And assume they will be rejected by others
  13. Dependent personailty disorder
    Cluster C

    anxious around others, fear of being abandoned. Fear that their own thoughts and feelings will result in rejection. Allow themselves to be manipulated.

    –Children with histories of separation anxiety may develop

    –Frequently seek treatment

    –Humanistic therapy may help foster sense of self

    –Cbt focuses on assertiveness training.
  14. Obsessive-Compulsive personality disorder
    Cluster C

    tensely control emotions, lack flexibility, detail oriented, more global than OCD. Perfectionistic but so much so that not very productive

    psychodynamics emphasize fixation on anal stage
  15. Problems with personality disorders
    1. Categories are presented as distinct from normality, but research has shown they’re just extremes of normal behavior.

    2. Overlap in diagnostic categories. May actually be fewer disorders than we think.

    3. Diagnosis requires information that’s hard to get E.g. from adolescence

    4. Presented as stable over time, but research has shown that variation exists across time.
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abnormal psych: personality disorders
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